PHILIP D. MURPHYGovernor

~tate n£ ~ tfu mtrSeuDEPARTMENT OF HEALTH

PO BOX 360TRENTON, N.J. 08625-0360

www.oj.gov/health

SHEILA Y. OLIVERLt. Governor March 16, 2020

JUDITH M. PERSICHILLI, RN, BSN, MACommissioner

TO: AdministratorsMental Health Programs licensed pursuant to N.J.A.C. 10:37ASubstance Use Disorder Programs licensed pursuant to N.J.A.C. 10:161A

FROM: Marcela Ospina Maziarz, MDeputy CommissionerHealth Systems

SUBJECT: Mandatory Guidelines for Visitors and Facility Staff

Effective Tuesday, March 17, 2020 at 5 p.m. and until lifted by theDepartment of Health (Department), the following screening and restrictionrequirements for all visitors to your facility shall be implemented by your facility.

Effective Tuesday, March 17, 2020 at 5 p.m. and until further notice by theDepartment, the following screening and restriction requirements for facility staffshall be implemented by your facility.

Mandatory Guidelines for Visitors and Facility Staff

DefinitionsRestricting means the individual should not be allowed in the facility at all,

until the Department lifts the requirements of this memorandum.

1. Limiting Resident Visitation

The following rules shall apply to resident visitors:

a. The facility shall actively screen and restrict visitation for those who meet oneor more of the following criteria:

I. Exhibit signs or symptoms of a respiratory infection, such as a fever(evidenced by a temperature check of the visitor taken by the facility),

cough, shortness of breath, or sore throat;II. In the last 14 days, has had contact with someone with a confirmed

diagnosis of COVID-19, or under investigation for COVID-19, or are illwith respiratory illness;

iii. In the last 14 days, has traveled internationally to a country withsustained community transmission. For updated information onaffected countries visit: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html; or

IV. Resides in or travels to a community where community-based spread ofCOVID-19 is occurring.

b. If, after undergoing screening, the visitor is permitted to enter the facility, thefacility shall:

I. Ask the visitor if he or she had any recent trips (within the last 14 days)on cruise ships or participated in other settings where crowds areconfined to a common location. If the answer is yes, then it isrecommended that the facility offer the visitor a facemask to use whileonsite.

II. Provide instruction, before the visitor enters the facility and resident'sroom, on hand hygiene, the location of handwashing stations, limitingsurfaces touched, and use of PPE according to current facility policywhile in the resident's room;

iii. Limit the visitor's movement within the facility to the resident's room (e.g.,reduce walking the halls, avoid going to dining room, etc.); and

iv. Advise the visitor to limit physical contact with anyone other than theresident while in the facility. For example, practice social distancing withno handshaking or hugging and remaining six feet apart.

2. Alternatives to Resident Visits

In lieu of visits, the Department suggests that facilities consider:

a. Offering alternative means of communication for people who would otherwisevisit, such as virtual communications (phone, video-communication, etc.).

b. Creating/increasing listserv communication to update families, such asadvising to not visit.

c. Assigning staff as primary contact to families for inbound calls and conductregular outbound calls to keep families up to date.

d. Offering a phone line with a voice recording updated at set times (e.g., daily)with the facility's general operating status, such as when it is safe to resumevisits.

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3. Vendors

a. For vendors and transportation providers (e.g., when taking residents tooffsite appointments, etc.), the facility shall actively screen and restrict thoseindividuals from entering the facility if they meet one or more of the followingcriteria:

I. Exhibit signs or symptoms of a respiratory infection, such as a fever(evidenced by a temperature check of the individual taken by the facility),cough, shortness of breath, or sore throat;

ii. In the last 14 days, has had contact with someone with a confirmeddiagnosis of COVID- 19, or under investigation for COVID-19, or are illwith respiratory illness;

iii. In the last 14 days, has traveled internationally to a country with sustainedcommunity transmission. For updated information on affected countriesvisit: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html; or

b. If, after undergoing screening, the vendor or transportation provider ispermitted to enter the facility, the facility shall:

I. Ask the vendor or transportation provider if he or she had any recent trips(within the last 14 days) on cruise ships or participated in other settingswhere crowds are confined to a common location. If the answer is yes,then it is recommended that the facility offer the individual a facemask touse while onsite.

ii. Provide instruction, before the individual enters the facility, on handhygiene, the location of handwashing stations, limiting surfaces touched,and use of PPE according to current facility policy;

III. Limit the individual's movement within the facility to those areasnecessary to complete the vendor's or transportation provider's task; and

IV. Advise the individual to limit physical contact with anyone in the facility.For example, practice social distancing with no handshaking or huggingand remaining six feet apart.

c. For supply vendors, it is recommended that they drop off supplies at adedicated location, such as a loading dock, instead of entering the facility.Medication and/or other supplies that must be received by an employeeshould follow customary drop off procedures.

4. Monitoring and Restricting Health Care Facility Staff and MedicalProfessional Visitors

a. The facility shall actively screen and restrict health care facility staff andmedical professional visitors (e.g., physicians, APN's, nurses, counselors,LSCW, LAC, LPC, LCADC, CADC, LSW, and LMFT) who meet the followingcriteria:

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I. Exhibit signs or symptoms of a respiratory infection, such as fever(evidenced by a temperature check of the staff member or medicalprofessional taken by the facility), cough, shortness of breath, or sorethroat;

II. In the last 14 days, has had contact with someone with a confirmeddiagnosis of COVID- 19, or under investigation for COVID-19, or are illwith respiratory illness;

III. In the last 14 days, has traveled internationally to a country withsustained community transmission. For updated information onaffected countries visit: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html; or

IV. Resides in or travels to a community where community-basedspread of COVID-19 is occurring.

b. If, after undergoing screening, the staff member or visiting medicalprofessional is permitted to enter the facility, the facility shall:

I. Ask the individual if he or she had any recent trips (within the last 14days) on cruise ships or participated in other settings where crowds areconfined to a common location. If the answer is yes, then it isrecommended that the facility offer the individual a facemask to use whileonsite; and

ii. Provide instruction, before the individual enters the facility, on handhygiene, the location of handwashing stations, limiting surfaces touched,and use of PPE according to current facility policy.

c. Health care facility staff who have signs and symptoms of a respiratoryinfection should not report to work.

d. Any staff that develop signs and symptoms of a respiratory infection while on-the-job, are required to:

I. Immediately stop work, put on a facemask, and self-isolate at home;lnformthe facility's infection preventionist, and

II. include information on individuals, equipment, and locations the personcame in contact with; and

iii. Contact their health care provider.

e. Refer to the CDC guidance for exposures that might warrant restrictingasymptomatic healthcare personnel from reporting to work(https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html)

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Facilities should contact their local health depart ent for questions, and frequentlyreview the CDC website dedicated to COVID-19 for health care professionals(https:llwww.cdc.gov/coronavirus/2019-nCoV/hcp/index.html) and the New JerseyDepartment of Health Website for COVID-19:https://www.nj.gov/health/cd/topics/ncov.shtml.

If you have any questions concerning this matter, please contact Ms. JeanDeVitto, Executive Director, Certificate of Need and Healthcare Facility LicensureProgram at jean.devitto@doh.nLgov.

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